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Table 15 Studies of SPG neurostimulation

From: Sphenopalatine ganglion: block, radiofrequency ablation and neurostimulation - a systematic review

Neurostimulation
First author Year Medical problem Stimulator Approach Imaging Types of stimulation How to identify the right spot Study design Number of cases Outcome
Tepper et al. [45] 2009 Intractable migraine Medtronic model 3625 or 3628 Infrazygomatic approach Fluoroscopy Customized, average amplitude, 1.2 V, pulse rate 67 Hz, pulse width 462 μs Paresthesia with stimulation at the back of the nose and deep in the back of the soft palate Case only 11 2 pain-free, 3 had pain reduction, 5 had no response, 1 was not stimulated
Ansarinia et al. [44] 2010 Cluster headache Medtronic model 3625 Pterygopalatine fossa Fluoroscopy Customized, average amplitude, 1.7 V, frequency 88 Hz, pulse width 294 μs paresthesia with stimulation in the posterior nasopharynx and root of the nose Case only 6 Total 18 CH attacks, complete resolution with SPG stimulation in 11 attacks, partial in 3, no relief in 4.
Schoenen et al. [41] 2013 Cluster headache ATI SPG stimulator Pterygopalatine fossa proximate to the sphenopalatine ganglion CT Customized, mean frequency 120.4 Hz, mean pulse width 389.7 μs, mean intensity 1.6 mA X-ray Randomized controlled 28 cases, with 3 randomized settings. Pain relief achieved in 67.1% of full stimulation-treated attacks compared to 7.4% of sham-treated attacks. P < 0.0001
Elahi et al. [47] 2015 Idiopathic right facial pain Medtronic model 3378 The pterygopalatine fossa Fluoroscopy 0.5 mV, pulse width 250 – 450 μs, and 40 – 80 Hz X-ray Case report 1 2/10 pain on 6-month follow-up
Meng et al. [88] 2016 Cluster headache Medtronic model 3487A Pterygopalatine fossa Fluoroscopy Bilateral stimulation, right 0-, 1+, 130 Hz, 120 μs, 0.7 V; left 8-, 9+, 130 Hz, 120 μs, 0.8 V X-ray Case report 1 Headache frequency reduced to once a week, pain level 1/10 at 4 months
William et al. [46] 2016 Idiopathic facial pain, supraorbital neuropathy, hemicrania continua, facial anesthesia dolorosa, occipital neuropathy Medtronic Subcompact Octrode SPG Fluoroscopy Unknown X-ray Case series 5 80% reported sustained facial pain at mean follow-up of 9.6 months.
Jurgens et al. [42] 2016 Cluster headache Neurostimulator, described in [41] Pterylopalatine fossa CT Customized, applied as soon as the patient feels cluster headache attacks X-ray Cohort study. Long-term follow-up from [41] 33 cases 61% of patients were either acute responder (>50% relief from moderate or greater pain) or frequency responder (>50% in attack frequency) at 24 months
Barloese et al. [43] 2016 Cluster headache Neurostimulator, described in [41] Pterylopalatine fossa CT Customized, applied as soon as the patient feels cluster headache attacks X-ray Cohort study. Long-term follow-up from [41] 33 cases 30% experienced at least 1 episode of complete attack remission (attack-free period exceeding 1 month).
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